Summary of included studies.

Background
Effective nutrition management is fundamental in the comprehensive treatment of individuals with type 2 diabetes. Various strategies have been explored in this regard, demonstrating their potential usefulness in improving clinical outcomes. This systematic review aims to assess the impact of meals frequency on the well-being of these patients.
Methods and findings
In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases were searched until July 10th, 2023. We included studies from the last 10 years in people with type 2 diabetes that had an intervention regarding their meal frequency. The risk of bias was evaluated based on the Cochrane tool according to the type of study. Of 77 retrieval articles, 13 studies matched our inclusion criteria. The primary focus of each study was to evaluate glycemic control as the major outcome. Studies suggest that meal frequency, time-restricted feeding, breakfast skipping, bedtime snacking, and chrononutrition practices all play roles in type 2 diabetes management and risk.
Conclusions
Restricting feeding to 2 to 3 meals per day and practicing time restricted feeding with less than 10 hours of daily food intake promotes weight loss and glycemic control in patients with type 2 diabetes. Aligning food consumption with the body’s natural rhythm is beneficial, whereas skipping breakfast disrupts this rhythm. Snacking after evening or waiting 3–4 hours after meal helps control glucose levels, but consuming pre-bedtime snacks do not provide the same benefits.
PROSPERO registration number
CRD42023431785.

背景
有效的营养管理是2型糖尿病（type 2 diabetes）患者综合治疗的核心基础。目前学界已针对该领域探索了多种干预策略，均展现出改善临床结局的潜在应用价值。本系统综述旨在评估用餐频率对该类患者健康状况的影响。

方法与结果
本研究遵循系统综述与Meta分析优先报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南，检索了PubMed、Embase、Web of Science、Cochrane图书馆及Google Scholar数据库，检索时限截至2023年7月10日。纳入近10年内针对2型糖尿病患者开展的用餐频率干预相关研究，并根据研究类型采用Cochrane偏倚风险评估工具对纳入研究的偏倚风险进行评价。最终从77篇检索文献中筛选出13篇符合纳入标准的研究。所有纳入研究均以血糖控制作为主要结局指标。现有研究表明，用餐频率、限时进食（time-restricted feeding）、不吃早餐、睡前加餐以及时间营养学（chrononutrition）干预手段，均对2型糖尿病的管理及疾病风险存在影响。

结论
将每日进食限制为2~3餐，以及采用每日进食窗口小于10小时的限时进食方案，可促进2型糖尿病患者的体重控制与血糖改善。将进食时间与人体自然生理节律相匹配具有获益，而不吃早餐则会打破该节律。晚间加餐或餐后间隔3~4小时再进食有助于控制血糖水平，但睡前加餐无法带来同等获益。

PROSPERO注册编号：CRD42023431785。